Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis

• Published in: Journal of clinical and translational hepatology Vol. 9; no. 5; pp. 647 - 654
• Main Authors: Wang, Rui-Rui, Gu, Hong-Qiu, Wei, Ying-Ying, Yang, Jin-Xiang, Hou, Yi-Xin, Liu, Hui-Min, Yang, Zhi-Yun, Wang, Xian-Bo, Jiang, Yu-Yong
• Format: Journal Article
• Language: English
• Published: China XIA & HE Publishing Inc 28.10.2021
• Subjects: Original; Bacterial infection; Prognostic model; Spontaneous bacterial peritonitis; Long-term outcome; Nomogram; Liver cirrhosis; Predictors
• ISSN: 2225-0719; 2310-8819
• DOI: 10.14218/JCTH.2021.00031

Spontaneous bacterial peritonitis (SBP) is one of the leading causes of death in patients with liver cirrhosis. We aimed to establish a prognostic model to evaluate the 1-year survival of cirrhosis patients after the first episode of SBP. A prognostic model was developed based on a retrospective derivation cohort of 309 cirrhosis patients with first-ever SBP and was validated in a separate validation cohort of 141 patients. We used Uno's concordance, calibration curve, and decision curve (DCA) analysis to evaluate the discrimination, calibration, and clinical net benefit of the model. A total of 59 (19.1%) patients in the derivation cohort and 42 (29.8%) patients in the validation cohort died over the course of 1 year. A prognostic model in nomogram form was developed with predictors including age [hazard ratio (HR): 1.25; 95% confidence interval (CI): 0.92-1.71], total serum bilirubin (HR: 1.66; 95% CI: 1.28-2.14), serum sodium (HR: 0.94; 95% CI: 0.90-0.98), history of hypertension (HR: 2.52; 95% CI: 1.44-4.41) and hepatic encephalopathy (HR: 2.06; 95% CI: 1.13-3.73). The nomogram had a higher concordance (0.79) compared with the model end-stage liver disease (0.67) or Child-Turcotte-Pugh (0.71) score. The nomogram also showed acceptable calibration (calibration slope, 1.12; Bier score, 0.15±0.21) and optimal clinical net benefit in the validation cohort. This prediction model developed based on characteristics of first-ever SBP patients may benefit the prediction of patients' 1-year survival.